Cracking the Case of Achalasia-induced Syncopal Episode

Abstract

Achalasia is an uncommon disease that occurs due to inability of lower esophageal sphincter from relaxing, leading to dysphagia to liquids and solids. Clues to this diagnosis include: failed treatment with proton pump inhibitors, and changes on imaging studies including chest X-ray and barium esophagogram. Ultimately it is a diagnosis made on esophageal manometry. Swallow-induced syncope has been known in patients with achalasia for almost three centuries. Here we present the case of a patient with achalasia and a non-swallowing syncopal episode. To our knowledge and extensive search, there has been no report of a similar case.

Hypertrophic Osteopathy Concurrent with an Aberrant Right Subclavian Artery in a Dog

“…When an ARSA passes over the esophagus, it can lead to esophageal compression and dilation [ 14 , 18 ]. In response to the dilation of the esophagus, afferent fibers of the vagus nerve are stimulated through mechanoreceptors [ 28 , 29 ]. In the present case, chronic stimulation of the vagus nerve, induced by anomalous vessel-associated esophageal dilation, might have been the underlying cause of HO.…”